ASEAN cities protecting the gains of the HIV response during the COVID-19 pandemic

Fast-Track cities in South-East Asia have been stepping up efforts during the COVID-19 pandemic to ensure that HIV treatment and prevention services remain unaffected by the pandemic and to protect the gains made in the HIV response. The dynamic city-based infrastructures that have been built up around the HIV response are being leveraged to implement innovative programmes to safeguard people living with HIV and other vulnerable populations and contain the spread of COVID-19.

Jakarta, Indonesia, provides a clear example of how cities are accelerating their HIV responses, enabling continued progress while taking into account the effects of the COVID-19 pandemic. Since the first COVID-19 outbreak, Central Jakarta, with more than 10 000 people living with HIV on antiretroviral therapy, ensured treatment continuity with the implementation of multimonth antiretroviral therapy dispensing and community-led home-based delivery. In collaboration with partners, the Provincial Health Office of Jakarta developed the Jak-Anter service, which connects people living with HIV with health facilities across the metropolitan area, allowing for direct client-organized antiretroviral therapy delivery, benefiting nearly 30% of people living with HIV in the area.

This best practice was shared at an event, ASEAN Cities Getting to Zero: Protecting Fast-Track Cities’ Gains during the COVID-19 Pandemic, which brought together five cities from the Association of Southeast Asian Nations (ASEAN) on the margins of the Fast-Track cities 2021 hybrid conference in Lisbon, Portugal, on 21 October.

“Cities play a critical role in delivering on the United Nations Political Declaration on AIDS. As we make our collective steps towards the next phase of achieving the three zeroes, we must work in partnership to address the variety and complexity of HIV epidemics. Evidence-informed national regulations will ensure effective collaboration between national and subnational governments,” said Budi Gunadi Sadikin, the Minister of Health of Indonesia.

The event allowed ASEAN cities to share innovative practices in implementing HIV programmes amid the COVID-19 pandemic.

“ASEAN is committed to fast-tracking the HIV response to end AIDS by 2030. We must continue to work hand in hand and to ensure equitable access to HIV services and solutions, break down barriers and improve resource mobilization for efficient and sustainable HIV responses,” said Dato Lim Jock Hoi, the Secretary-General of ASEAN.

A recurring theme during the session was how quickly ASEAN cities utilized virtual platforms to scale up access to HIV services, especially during lockdowns. In the Philippines, Pasig City delivered quality services to key populations by increasing investments in HIV programmes and treatment facilities and the use of virtual platforms. Like Jakarta, Pasig City partnered with community-based organizations to deliver antiretroviral therapy, condoms and lubricants by establishing a service delivery network with service providers and health facilities to provide core packages of health-care services during the COVID-19 pandemic.

Can Tho, a city in Viet Nam, piloted a project to deliver self-test kits to key populations, in particular gay men and other men who have sex with men and people who use drugs, through virtual platforms. In collaboration with the World Health Organization and civil society partners, Can Tho quickly responded to COVID-19 by training community outreach workers to conduct community-based HIV rapid testing and by scaling up HIV self-testing.

Bangkok’s innovations included same-day delivery of antiretroviral therapy and the scale-up of key population-led health services. Bangkok, a regional leader in pre-exposure prophylaxis (PrEP) and a provider of specialized and holistic services for transgender people, expanded its PrEP services to 16 municipal public health centres and eight city hospitals during the COVID-19 pandemic.

Young people were noted as being at the forefront of the HIV response in ASEAN cities. In an effort to reduce the number of new HIV infections among young people in Langkawi, Malaysia, the Kedah State Health Department established the GLITZ project. The programme focuses on young people, including young key populations, through various outreach activities, mentor–mentee programmes and school and university visits to educate young people on HIV prevention. 

As the Fast-Track cities network continues to grow in the ASEAN region, the complexity of HIV in urban areas is better understood. The network offers a way for cities to share best practices and experiences at a time of increasing urbanization and globalization.

“It has been 10 years since the ASEAN Cities Getting to Zero project was initiated. Since then, the project has successfully expanded to 76 cities in the region. As we see more participating cities and significant signs of progress in the HIV response, I encourage avenues for South–South collaboration. Together, in partnership, we can end AIDS as a global health threat by 2030,” said Taoufik Bakkali, the Director, a.i., of the UNAIDS Regional Support Team for Asia and the Pacific.

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